The Bad News About Dandruff
Dandruff cannot be cured - it can only be controlled. This article is about the management and control of both the dry dandruff with its itchy white flakes, and the greasy variety that supports the growth of certain yeast fungi and other exotic flora.
Dandruff is a common scalp condition that affects most people at some time during their lives. It usually is first noticed when the sex hormones kick in, that is, during and after puberty. Before puberty dandruff is rare.
Medical texts define dandruff as the excessive shedding of dead skin cells from the scalp. Normal scalp skin sheds old cells every month. These old cells usually go unnoticed because there are very few of them at one time. But in a dandruff-plagued scalp, the skin cells can cycle every week or even every three or four days. The result of this rapid cycling is the dreaded white flakes seen on dark suits or shirts, to say nothing about the itching that often accompanies this rapid cycling of cells.
Causes of Dandruff
Many dermatologists think that dandruff is associated with a yeast fungus called Pityrosporum ovale (Pity ros' por um o va' le) or just simply P. ovale. This microscopic one-celled organism lives in the skin of everyone and usually causes no problem. It is only when it starts to proliferate that problems emerge. (Pityrosporum ovale is also known as Malassezia ovalis.)
The proliferation may be caused by an excessively oily scalp. P. ovale cannot synthesize the fatty acids they need to survive. They have to get these fatty acids from the oils secreted from the sebaceous glands adjacent to each hair follicle in the scalp. Scalps that are excessively oily are good breeding grounds for these one-celled organisms. In this oil-rich environment, they increase in number and probably contribute to rapid skin cycling and scaling.
The P. ovale theory of dandruff is convincing, but there may be factors other than yeast fungi that promote dandruff. Some of these factors are:
- Cold, dry weather. Dandruff is much more common in the winter where the weather outside is frightful, but the dry indoor heating is even more frightful.
- Bad hygienic habits. Infrequent shampooing, harsh shampoos, use of the wrong conditioners, and improper rinsing can all contribute to dandruff.
- Too frequent coloring of the hair. Coloring and all the heat-related torture that women undergo in beauty parlors certainly do not promote a healthy scalp.
- Long-term stress and anxiety. This is a low-probability cause of dandruff but it can't be ruled out.
- Bad diet. A diet rich in saturated fats and trans-fatty oils causes the sebaceous glands to produce more sebum - the delicacy that P. ovale, as well as other flora, thrive on.
- Hormonal changes. These changes, especially in a woman's body, can accelerate skin cell cycling.
Can Dandruff Lead to Baldness?
In severe cases of dandruff, for which the medical term is seborrheic dermatitis or seborrhea, some hair follicles could be damaged or destroyed. But there is no evidence in the medical journals that baldness is caused by ordinary dandruff. Dandruff and baldness often occur together though. Many people assume from this that one is caused by the other. It's a false assumption.
What Can Be Done?
If you have dandruff, the first thing I would suggest is to get a bottle of non-prescription 1% Nizoral Anti-Dandruff Shampoo. (This is now called Nizorelle Shampoo.) The prescription 2% Nizoral is for more severe cases of dandruff. After you shampoo with your regular shampoo and rinse it off, pour a little Nizoral into the palm of your hand, and massage it into the scalp. Leave it on for three to five minutes before thoroughly rinsing it off.
Do this two or three times a week for a month. If this rids your scalp of the dandruff problem, use Nizoral only once every week after your regular shampoo to prevent the dandruff from returning. The effect of Nizoral is long-acting so it is a good preventive measure.
The active ingredient in Nizoral is ketoconazole (ke to co' na zole). This chemical is effective in keeping the yeast fungus P. ovale in check. Even though I don't have dandruff anymore, I still use Nizoral at least once a month - just in case. It has a good fragrance, and, as the company says, "It is pH balanced leaving the hair soft, healthy, and clean."
Many other anti-dandruff shampoos work by changing or normalizing the pH of the scalp thereby making it harder for P. ovale to proliferate. The pH of scalp skin should be relatively neutral. The pH scale goes from 0 to14 with 0 extreme acid and 14 extreme alkaline. Neutral is a pH of 7 on the scale. Pure water has a pH of 7. Even though many shampoos (Nizoral included) claim to balance or neutralize the pH of the scalp, it is mostly the quality of the water that determines your scalp's pH after a shower.
If the water quality in your area is too hard or soft, it is especially important to use a good conditioner. Experiment to find one that is suitable for your hair, preferably a conditioner separate from the shampoo. Try this for a cheap conditioner: one part apple cider vinegar to three parts warm water. Rinse your hair with this. There is a health food store in Santa Barbara, California that claims miracles for apple cider vinegar: it balances the pH of you scalp along with your bank account and it keeps you going strong into old age.
As for shampoos, select a mild one preferably without the harsh detergents like sodium lauryl sulfate. It might also be best to avoid shampoos with plant oils in them. These plant oils promote the growth of P. ovale and could be allergenic. Jojoba is OK though. If you use oil to groom your hair, just plain mineral oil is the least damaging to the skin and hair. I use jojoba (ho ho' ba) to groom my hair.
Be careful of the sun. New studies have indicated that UVA penetrates 165 to 250 micrometers into the skin and can damage it and the hair follicles as well. The tanning salons, by the way, use UVA.
For controlling dandruff as well as for perhaps halting hair loss, I recommend a diet low in the tasty saturated fats you get in a good steak, and the trans-fatty acids you get in margarine. These fats and oils seem to make the sebaceous glands adjacent to the hair follicles more active, thereby producing a secretion rich in 5-alpha reductase and the nutrients (the fatty acids) that fungi love.
A diet high in vitamins (especially the B-Complex) and minerals from natural sources will ease your dandruff problems and perhaps your hair problems. The colorful fruits and vegetables that give you these nutrients are also good to eat. (But so are steaks.)
Some nutritionists claim that GLA (gamma-linolenic acid) will help people with a dandruff problem. This nutrient also promotes healthy skin and hair. The supplements evening primrose oil and black currant oil are rich sources of GLA.
A Short Summary
Unless you have seborrhea or another serious skin condition, the good hygienic habits I discussed in this article, plus Nizoral, and a healthful diet should control your dandruff. If it does not, perhaps a visit to a dermatologist would be wise.